Substituted nucleoside derivatives with antiviral and antimicrobial properties

ABSTRACT

The present invention relates to fatty acid and fatty alcohol substituted nucleoside derivatives and nucleoside and nucleoside derivatives substituted on multivalent scaffolds (e.g., polymers, peptides, polycarboxylic acid substituted compounds, compounds containing polycycloSaligenyl groups) that display potent anti-HIV activity. Furthermore, they show enhanced activity against multi-drug resistant, R5, and cell-associated virus. Some of them also display activity against other sexually transmitted pathogens and sperm. The present invention provides their methods of synthesis, composition of matter, and methods of use. Emphasis is placed on their application as topical microbicides to treat or prevent sexual transmission of disease, especially HIV/AIDS.

STATEMENT AS TO RIGHTS TO INVENTIONS MADE UNDER FEDERALLY SPONSOREDRESEARCH AND DEVELOPMENT

The present invention is supported in part by the CONRAD program(HRN-A-00-98-00020-00), administered under a cooperative agreementbetween the U.S. Agency for International Development (USAID) andEastern Virginia Medical School. The government may have certain rightsin this invention.

FIELD OF THE INVENTION

The invention generally relates to fatty acid or fatty alcoholsubstituted nucleoside derivatives and nucleoside and nucleosidederivatives substituted on multivalent scaffolds (e.g., polymers,peptides, polycarboxylic acid substituted compounds, compoundscontaining polycycloSaligenyl groups) that display activity against HIVand other sexually transmitted pathogens. These agents may be usedsystemically as therapeutic or preventative agents, or as topicalmicrobicides used to treat, prevent or reduce sexual transmission ofinfectious diseases, in particular, HIV/AIDS.

BACKGROUND OF THE INVENTION

The increasing prevalence of sexually transmitted diseases (STDs) is aserious public health problem affecting both developingresource-constrained countries. In the latter, the acquiredimmunodeficiency syndrome (AIDS) epidemic is taking a devastating tollin human lives. According to the World Health Organization, almost 40million people were living with HIV at the end of 2006, a year in which4.3 million people were newly infected and 2.9 million died ofAIDS-related diseases. Most new infections are occurring in thedeveloping world, where women are most vulnerable. In sub-SaharanAfrica, for example, 57% of people living with HIV are women, and youngwomen between 15 and 24 years old are at least three times more likelyto be HIV positive than young men.

There are no candidate vaccines in the pipeline that can inducesterilizing immunity and protect against infection with HIV. Therefore,there is an urgent need to develop additional safe and effectivepreventative strategies. One of those strategies has become known asmicrobicides, topically applied agents that prevent or reducetransmission of infectious disease, in particular HIV/AIDS (Lederman, M.M and Offord, R. E, Hartley, O. Nat Rev Immunol. 2006. 6: 371-382).

According to their mechanism of action, the microbicide pipelinecontains virucides (i.e., compounds that directly inactivate or destroythe virus), entry inhibitors, replication inhibitors, and integrationand post-integration inhibitors (Doncel, G. and Mauck, C. Curr HIV/AIDSRep. 2004. 1: 25-32). Within the replication or reverse transcriptaseinhibitors (RTIs), there are only a few, namely, UC-781(Thiocarboxanilide), TMC-120 (Dapivirine) and MIV-150(N-(5-cyano-2-pyridinyl)-N′-[1S,2S)-2-[6-fluoro-2-hydroxy-3-(1-oxopropyl)phenyl]cyclopropyl]urea)all non-nucleoside RTIs, and PMPA (Tenofovir), a nucleotide analogue.Although they are the most potent microbicides in development, theseagents, especially the non-nucleosides, have poor water solubility andhigh susceptibility to induce resistant virus. In part, this is due tothe fact that they act through a very specific, but single mechanism ofaction. They are also less effective against cell-associated virus.

Another factor that compounds the problem of fighting the epidemic isthe continued development of drug-resistant virus. New and more potentanti-HIV agents are constantly needed as existing therapies succumb tonewly developed resistant virus.

BRIEF SUMMARY OF THE INVENTION

The present invention relates to novel nucleoside derivatives andnucleoside conjugates. The compounds and compositions of the inventionmay be used systemically as therapeutic or preventative agents ortopically as microbicides that display potent anti-HIV activity,including against multi-drug resistant virus and cell-associated virus,as well as antimicrobial activity against certain STD pathogens.

Besides displaying antiviral cooperative effects, the compounds andcompositions of the invention offer an increased genetic barrier toresistance, reduced toxicity, and ease of formulation for topicalmicrobicidal applications. 12-Azidododecanoyl and 12-thioethyldodecanoylderivatives of the nucleosides are exemplary anti-HIV and microbicidalagents. These fatty acids may be connected in different ways to3′-fluoro-2′,3′-deoxythymidine (FLT), 2′,3′-dideoxy-3′-thiacytidine(lamivudine, 3TC), 2′,3′-didehydro-2′,3′-dideoxythymidine (stavudine,d4T), 2′,3′-dideoxy-5-fluoro-3′-thiacytidine (emtricitabine, FTC),2′,3′-dideoxycytidine (zalcitabine, ddC), 3′-azido-3′ deoxythymidine(zidovudine, AZT), and tenofovir (FIG. 2).

In addition to direct ester derivatives, the fatty acids or fattyalcohols are linked to the nucleosides through other linkers and/orscaffolds, including phosphoramidate, phosphotriesters, phosphodiesters,phosphomonoesters, triglycerides, linear peptide backbones, cyclicpeptide backbone, hydroxyphenyldicarboxylic acid derivatives, andcompounds containing multi cycloSaligenyl groups. Linear and cyclicpeptides can have glutamic acid or aspartic acid for the attachment ofnucleosides and serine or threonine for the attachment of fatty acids.The number of amino acids can be of an desired length, preferably 1-25.Amino acids can be L or D. Polycarboxylic acid derivatives used asscaffolds for nucleosides conjugation include tribenzenetriacetic acid,hydroxybenzendicarboxylic acid, [(hydroxyphenylene)dixoy]diacetic acid,tris(carboxymethoxy)benzene, (triazinetriyltroxy)triacetic acid,triazine-tricarboxylic acid derivatives, such as(triazinetriyltroxy)triacetic acid and1,3,5-triazine-2,4,6-tricarboxylic acid. Scaffolds containing one tothree 2-hydroxybenzyl alcohol are conjugated through a phosphotriester(cycloSaligenyl phosphotriester) to nucleosides and/or fatty alcohols.

Exemplary fatty acid derivatives are attached directly to FTC, 3TC, d4T,ddC, AZT, and FLT through an ester bond as microbicidal agents. FTC,3TC, d4T, ddC, AZT, and FLT derivatives attached through linkers tofatty acids or fatty alcohols, such as 12-azidododecanoyl and12-thiododecanoyl derivatives, are contemplated anti-HIV andmicrobicidal agents. In an aspect, the invention is related todevelopment of multivalent-nucleoside conjugates, such as novelpolyanionic derivatives of nucleosides, peptide derivatives ofnucleosides, small chemical scaffolds containing polycarboxylic acidsconjugated to nucleosides, and 2-hydroxybenzyl alcohol-nucleosidephosphodiester conjugates (cycloSaligenyl-nucleoside conjugates). Thepresent invention is directed to these and other important ends.

According to an aspect, the present invention provides compounds thatare substituted with one or more nucleosides, nucleotides ornucleoside(tide) derivatives wherein one of its substitutions may be along-chain fatty acid or fatty alcohol, which may be attached directlyor indirectly through a linker or scaffold to the nucleoside/tide asshown in Formulas I-VIII (FIGS. 3 a-3 c).

The nucleoside analogues in Formulas I-VIII may, in exemplary aspects,be pyrimidine derivatives based on the structures of 3′-deoxythymidine,3′-deoxyuridine, 3′-deoxycytidine, 3-thiacytidine, their stereoisomers,their modified forms with substitutions at positions 5, 6, andsubstitutions at positions 1′,2′,3′,4′, and 5′ of carbohydrate moiety,purine nucleosides based on the structures of 3′-deoxyguanidine,3′-deoxyadenosine, their modified forms with substitutions at positions2, 4, 6, 8, and/or N4 of base moiety, substitutions at positions 2′, 3′,and 5′ of carbohydrate moiety, and/or double bond between C3′ and C4′ incarbohydrate moiety or other nucleoside derivatives known to thoseskilled in the art.

In another aspect, the nucleoside derivative in Formulas I-VIII may be3′-azido-3′ deoxythymidine (AZT), 3′-fluoro-3′-deoxythymidine (FLT),2′,3′-dideoxy-3′-thiacytidine (3TC),2′,3′-dideoxy-didehydro-2′,3′-deoxythymidine (d4T),2′,3′-dideoxycytidine (ddC), or(−)-β-2′,3-dideoxy-5-fluoro-3′-thiacytidine (FTC).

In another aspect, the nucleotide derivative in Formulas I-VIII may be apyrimidine derivative based on the structures of 3′-deoxythymidine,3′-deoxyuridine, 3′-deoxycytidine, 3-thiacytidine, their stereoisomers,their modified forms with substitutions at positions 5, 6, andsubstitutions at positions 1′, 2′, 3′, 4′, and 5′ of carbohydratemoiety, purine nucleosides based on the structures of 3′-deoxyguanidine,3′-deoxyadenosine, their modified forms with substitutions at positions2, 4, 6, 8, and/or N4 of base moiety, substitutions at positions 2′, 3′,and 5′ of carbohydrate moiety, and/or double bond between C3′ and C4′ incarbohydrate moiety or other nucleoside derivatives known to thoseskilled in the art, attached to a phosphate group as phosphomonoester,phosphodiester, phosphotriester, cyclic phosphotriester, cyclicphosphite triester, or phosphoramidate triester.

In another aspect, the fatty acid in Formulas I-VIII may be of thegeneral formula X(CH₂)_(n)Y(CH₂)_(n)COOH or CH₃(CH₂)_(n)CH(Br)COOH andthe fatty alcohol is X(CH₂)_(n)Y(CH₂)_(n)CH₂OH orCH₃(CH₂)_(n)CH(Br)CH₂OH, wherein n=0-18; X═CH₃, N₃, alkyl-S, alkyl-O,aryl-O, aryl-S, alkyl-NH, aryl-NH, Br, Cl, F, I, OH, NH₂, COOH, CHO,CH₃S, aryl, heteroaryl, phenyl, alkene, alkyne, or substituted phenyl;and Y═CH₂, O, S, NH, or 1,2,3-triazole.

Scaffolds are defined as skeleton, core, or template of the structure towhich multiple functional groups and moieties may be attached. Thescaffolds may have multiple positions for multivalent linkages.Non-limiting exemplary scaffolds may be polymers or smaller moleculescontaining several functional groups (e.g., hydroxyl, amino, orcarboxylic acid groups) for attaching to other compounds. Scaffolds maybe directly or indirectly attached through linkers to active componentsof the conjugates, such as nucleosides or nucleoside derivatives.Scaffolds are preferably able to attach more than two molecules directlyor indirectly through linkers or spacers.

Linkers or spacers are flexible or rigid moieties which may be used toattach the scaffolds to functional groups and substituents of theconjugates, such as nucleosides or nucleoside derivatives, or to connectdirectly two or more active components, such as several nucleosides ornucleoside derivatives. In another aspect, the linker in Formulas I-VIIImay be alkyl and/or aryl chains with different lengths,phosphoglycerate, phosphoramidate, phosphomonoester, phosphodiester,phosphotriester, cyclic phosphotriesters, cyclic phosphite triesters,2-hydroxybenzyl alcohol, cycloSaligenyl groups, acetate, dicarboxylicacid esters (—OOC—(CH₂)_(n)—COO—, n=0-14 such as succinate or suberate),L or D-amino acyl (—NH—(CHR)_(n)—CO—, R═H or side chains of amino acids,n=1-25 such as γ-aminobutyric acid, glutamic acid, aspartic acid,serine, threonine forming linear or cyclic peptides), polyethers (e.g.,ethylene glycol ethers (—OCH₂CH₂O)_(n)—, n=1-14), carboxylic acid estersethers (—OOC—(CH₂)_(n)—CH₂O—, n=0-14), polyamides, or any combination ofthe linkers.

In another aspect, the scaffold in Formulas I-VIII may be derivativescontaining one to three 2-hydroxybenzyl alcohol (e.g.,4,4′-dihydroxy-3,3′-di-(hydroxymethyl)diphenylmethane,4,6-dihydroxy-1,3-benzenedimethanol,4,4′,4″-methanetriyltris(2-(hydroxymethyl)phenol)), polycarboxylic acids(e.g. tribenzenetriacetic acid, hydroxybenzendicarboxylic acid,[(hydroxyphenylene)dixoy]diacetic acid, tris(carboxymethoxy)benzene, andtriazine-tricarboxylic acid derivatives, such as(triazinetriyltroxy)triacetic acid and1,3,5-triazine-2,4,6-tricarboxylic acid), and anionic polymers(cellulose sulfate, cellulose sulfate acetate, dextran sulfate,naphthalene sulfonate derivatives, polystyrene sulfonate, carrageenans,polycarboxylic acid, or polyvinylpyrrolidone, and where otherpolyanionic compounds are polyphosphorylated polymers, suramin,cyclodextrin sulfate, or multisulfated and multiphosphorylated peptidesand alkyl chains).

In another aspect, the compounds of Formulas I-VIII display antiviraland/or antimicrobial activity.

In another aspect, the compounds of Formulas I-VIII display anti-HIVactivity.

In one aspect, the compounds of Formulas I-VIII may be in the form of acomposition which comprises a carrier, additive, or excipient.

In another aspect, the compounds of Formulas I-VIII may be in the formof a composition which may be used to treat or prevent infection,transmission, or acquisition of HIV/AIDS.

In another aspect, the compounds of Formulas I-VIII may be in the formof a composition that may be applied vaginally, anally, rectally andover the penis and other areas of the body to prevent sexualtransmission of pathogens, in particular, that of HIV.

In another aspect, the compounds of Formulas I-VIII may be in the formof a composition that may be used as a microbicide to prevent or reducesexual transmission of pathogens such as HIV, herpes simplex virus(HSV), human papilloma virus (HPV), Chlamydia trachomatis (CT),Neisseria gonorrhoeae (NG), Haemophilus ducreyi (HD) and others.

In another aspect, the compounds of Formulas I-VIII may be in the formof a composition that may be used as a contraceptive, especially forvaginal application.

In another aspect, the compounds of Formulas I-VIII may be in the formof a composition that may be used in a method for preventing or reducingsexual transmission of pathogens by delivering the composition of matterof formulas I-VIII in solid or semi-solid forms, such as a tablet, gel,cream, ointment, pessary, or by virtue of a cervical/vaginal device suchas a ring, cap, diaphragm or the like.

In another aspect, the compounds of Formulas I-VIII, or their parentnucleosides, may be chemically linked to another compound directly orthrough a linker, wherein the other compound is another nucleoside, apolymer, or a polyanionic molecule, wherein this compound is cellulosesulfate, cellulose sulfate acetate, dextran sulfate, naphthalenesulfonate derivatives, polystyrene sulfonate, carrageenans,polycarboxylic acid, polyvinylpyrrolidone, or cyclodextrin sulfate, andwhere other polyanionic compounds are polyphosphorylated polymers,suramin, or multisulfated and multiphosphorylated peptides and alkylchains.

In another aspect, a multivalent scaffold may be used to attach one ormore of the compounds of Formulas I-VIII, or its parent nucleoside,wherein the scaffold may be a derivative containing one to three2-hydroxybenzyl alcohol (e.g.,4,4′-dihydroxy-3,3′-di-(hydroxymethyl)diphenylmethane,4,6-dihydroxy-1,3-benznedimethanol,4,4′,4″-methanetriyltris(2-(hydroxymethyl)phenol)), polycarboxylic acids(e.g. tribenzenetriacetic acid, hydroxybenzendicarboxylic acid,[(hydroxyphenylene)dixoy]diacetic acid, tris(carboxymethoxy)benzene, andtriazine-tricarboxylic acid derivatives, such as(triazinetriyltroxy)triacetic acid and1,3,5-triazine-2,4,6-tricarboxylic acid), and anionic polymers(cellulose sulfate, cellulose sulfate acetate, dextran sulfate,naphthalene sulfonate derivatives, polystyrene sulfonate, carrageenans,polycarboxylic acid, or polyvinylpyrrolidone, and where otherpolyanionic compounds are polyphosphorylated polymers, suramin,cyclodextrin sulfate, or multisulfated and multiphosphorylated peptidesand alkyl chains).

In another aspect, the compounds of Formulas I-VIII, or their parentnucleosides, may be chemically linked to another compound, wherein theother compound displays anti-HIV properties, wherein the anti-HIV agentis cellulose sulfate, cellulose sulfate acetate, cellulose acetate,suramin, dendrimers, cyclodextrins, or another reverse transcriptaseinhibitor (RTI). In a further embodiment, the RTI may be a nucleoside(eg, AZT, FLT, 3TC, 4dT, FTC, ddC), nucleotide (eg, tenofovir),non-nucleoside (eg, efavirenz, nevirapine, delavirdine, dapivirine,UC-781, MW-150) or one of its analogues.

In another aspect, the compounds of Formulas I-VIII or one or morenucleoside or nucleotide analogs may be linked to a scaffold directly orthrough a linker in the presence or absence of fatty acids or fattyalcohols.

In another aspect, the compounds of Formulas I-VIII, or their parentnucleosides, may be chemically linked to another compound to provide acomposition of matter and may contain a carrier or excipient. In anotheraspect, the composition of matter may be used to treat or preventinfection or transmission of HIV/AIDS and may be applied vaginally,anally, rectally and over the penis and other areas of the body toprevent sexual transmission of pathogens, in particular, that of HIV. Inanother aspect, the composition of matter may be used as a microbicideto prevent or reduce sexual transmission of pathogens such as HW, HSV,HPV, CT, NG, HD and others. In another aspect, the composition of mattermay be used as a contraceptive, especially for vaginal application.

In another aspect, the compounds of Formulas I-VIII, or their parentnucleosides, may be chemically linked to another compound to provide acomposition of matter and may contain a carrier or excipient, and may beused in a method for treating, preventing, or reducing sexualtransmission of pathogens by delivering the composition of matter insolid or semi-solid forms, such as a tablet, film, gel, cream, ointment,pessary or by virtue of a cervical/vaginal device such as a ring, cap,diaphragm, or the like.

In another aspect, the compounds of Formulas I-VIII, or their parentnucleosides, may be chemically linked to another compound to provide acomposition of matter and may contain a carrier or excipient, and may beused in a method for preventing conception and pregnancy by deliveringany of the compositions of matter disclosed above intravaginally in theform of a solid or semi-solid or by virtue of a device such as a ring,cap, diaphragm or the like.

In another aspect, the compounds of Formulas I-VIII, or their parentnucleosides, may be chemically linked to another compound to provide acomposition of matter and may contain a carrier or excipient, and may beused in a method for preventing or treating HIV infection as part of acombination product, wherein the other components of the product areother nucleoside, nucleotide, and non-nucleoside RTIs, or proteaseinhibitors, or integrase inhibitors or entry/fusion inhibitors, or otherHIV inhibitors known to those skilled in the art.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 shows the general format of conjugation between nucleosides,linker, fatty acids or fatty alcohols, and scaffolds.

FIG. 2 displays general chemical structures of some of thenucleoside-fatty acid, nucleoside-fatty alcohol, multivalentscaffold-nucleoside conjugates.

FIG. 3 a shows the general chemical structures of the claimed compounds(Formulas I-VI).

FIG. 3 b shows the general chemical structures of the claimed compounds(Formula VII).

FIG. 3 c shows the general chemical structures of the claimed compounds(Formula VIII).

FIG. 4 depicts the general strategies for the synthesis ofnucleoside-fatty acid conjugates and nucleoside-polyanionic analogueconjugates.

FIG. 5 depicts the synthesis of lamivudine derivatives.

FIG. 6 depicts the synthesis of an AZT-succinate-sodium cellulosesulfate conjugate.

FIG. 7 depicts the synthesis of a FLT-succinate-sodium cellulose sulfateconjugate.

FIG. 8 depicts the synthesis of an AZT-suramin conjugate.

FIG. 9 depicts the flexible and rigid linkers for the synthesis ofconjugates of nucleoside-polyanionic derivatives.

FIG. 10 shows vaginal cell toxicity of fatty acid derivatives of FLT.

FIG. 11 shows IL-1 alpha production by human vaginal cells incubatedwith fatty acid derivatives of FLT.

FIG. 12 displays the chemical structures of tetradecanol etherderivatives of FLT and AZT.

FIG. 13 depicts the synthesis of 5′-carboxyfluorescein derivatives ofFLT through different linkers

FIG. 14 shows the cellular uptake studies for 5(6)-carboxyfluoresceinderivatives of FLT along with FAM and DMSO as controls at different timeintervals.

FIG. 15 demonstrates the cellular uptake studies for5(6)-carboxyfluorescein derivatives of FLT along with FAM and DMSO ascontrols at different concentrations.

FIG. 16 shows the cellular uptake studies for 5(6)-carboxyfluoresceinderivatives of FLT along with FAM and DMSO as controls after treatmentwith trypsin.

FIG. 17 shows real time fluorescence microscopy in live CCRF-CEM cellline. C=Control, FAM=5(6)-carboxyfluorescein.

FIG. 18 depicts the chemical structures of some of peptide-nucleosideconjugates with two or three nucleosides and with or without myristicacid.

FIG. 19 shows the chemical structures of peptide-nucleoside conjugatescontaining myristic acid and one nucleoside.

FIG. 20 depicts the synthesis of peptide-nucleoside conjugatescontaining myristic acid and one nucleoside.

FIG. 21 illustrates the synthesis ofFLT(myristoylglutamyl)-mysritoyllysine (KPH-92).

FIGS. 22-24 depict the synthesis of some of peptide-nucleosideconjugates with two or three nucleosides (with or without myristicacid).

FIG. 25 displays the synthesis of nonsymmetrical nucleoside-nucleosideconjugates using a succinate linker.

FIG. 26 depicts the synthesis of symmetrical nucleoside-nucleosideconjugates using a succinate or suberate linker.

FIGS. 27-28 show the synthesis of cycloSaligenyl derivatives containingtwo nucleotides.

FIG. 29 shows the synthesis of cycloSaligenyl derivatives containingthree nucleotides.

FIG. 30 depicts the synthesis of tricarboxylic acid ester derivatives ofnucleosides and fatty acid-dicarboxylic ester conjugates of nucleosides.

DETAILED DESCRIPTION OF THE INVENTION

For the purposes of promoting an understanding of the principles of theinvention, reference will now be made to preferred embodiments andspecific language will be used to describe the same. It willnevertheless be understood that no limitation of the scope of theinvention is thereby intended, such alteration and further modificationsof the invention, and such further applications of the principles of theinvention as illustrated herein, being contemplated as would normallyoccur to one skilled in the art to which the invention relates.

The term “alkyl” as used herein denotes an unbranched or branched chainhydrocarbon residue containing 1 to 18 carbon atoms. The term “aryl” asused herein denotes an optionally substituted monocyclic orpolycyclic-aromatic group comprising carbon and hydrogen atoms. Examplesof suitable aryl groups include, but are not limited to, phenyl andnaphthyl (e.g. 1-naphthyl or 2-naphthyl). The term “amino acid” as usedherein refers to naturally occurring alpha amino carboxylic acids, aswell as to optical isomers (enantiomers and diastereomers), syntheticanalogs and derivatives thereof. The term “protecting group” as usedherein means a chemical group that (a) preserves a reactive group fromparticipating in an undesirable chemical reaction; and (b) can be easilyremoved after protection of the reactive group is no longer required.

A “nucleoside” contains a heterocyclic nitrogenous base, either adenine(A), guanine (G), cytosine (C), or uracil (U) joined to a ribose ordeoxyribose. As used herein, a “nucleoside” includes a naturallyoccurring or synthetic nucleoside, nucleoside analog, or nucleosidederivative thereof. A “nucleoside analog” as used herein includes ananalog of ribonucleosides and deoxyribonucleosides and the triphosphatesthereof. For instance, structural groups are optionally added to thesugar or base of a nucleoside, such as a methyl or allyl group at the2′-0 position on the sugar, or a fluoro group which substitutes for the2′-O group, or a bromo group on the nucleoside base. A “nucleosidederivative” as used herein includes a nucleoside or a nucleoside analogattached to a phosphate group as phosphomonoester, phosphodiester,phosphotriester, cyclic phosphotriester, cyclic phosphite triester, orphosphoramidate triester.

By “complex” is meant a compound which is made up structurally of two ormore compounds or ions, that is, a compound formed by a combination ofsubstances that are themselves capable of independent existence. In anaspect, “complex” describes the chemical moiety produced by theinteraction of two or more of the substituents disclosed herein.

Scaffolds are defined as skeleton, core, or template of the structurethat multiple functional groups and moieties are attached. The scaffoldsmay have multiple positions for multivalent linkages. The scaffolds maybe polymers or smaller molecules containing several functional groups(e.g., hydroxyl, amino, or carboxylic acid groups) for attaching toother compounds. Scaffolds may be directly or indirectly attachedthrough linkers to active components of the conjugates, such asnucleosides or nucleoside derivatives. Scaffolds are able to attach morethan two molecules directly or indirectly through linkers or spacers.

Linkers or spacers are flexible or rigid moieties used to attach thescaffolds to the active components of the conjugates, such asnucleosides or nucleoside derivatives, or to connect directly two ormore active components, such as several nucleosides or nucleosidederivatives.

This invention provides novel fatty acid or fatty alcohol substitutednucleoside derivatives and nucleoside multivalent scaffold (e.g.,polyanionic polymers, peptides, polycarboxylic acids, polycycloSaligenygroups) conjugates displaying potent anti-HIV activity. These agents maybe used systemically for the treatment or prevention of HIV/AIDS. Theymay also be used as topical microbicides to prevent acquisition of HIVinfection through skin and mucosa. The invention provides compounds thatare ideal candidates for this application preventing the acquisition ofsexually transmitted disease.

The present invention provides methods of synthesis, compositions ofmatter and applications of newly discovered substituted nucleoside andnucleoside-multivalent scaffolds conjugates.

The fatty acid, fatty alcohol, peptides, polycarboxylic acids,phosphodiesters, and polyanionic conjugates of nucleoside analogues arebased on the general Formula I-VIII (FIGS. 3 a-c), wherein one or moreof 3′-deoxynucleosides are attached directly or indirectly through alinker to long chain fatty acids, long chain fatty alcohols, peptides,polycarboxylic acids, polyanionic molecules (e.g., polysulfatedcarbohydrates), or both at 5′-position of the carbohydrate moiety and/orN4 position of base moiety of nucleoside analogues.

The nucleoside analogues are based on the general Formula I-VIII,wherein nucleoside analogues are pyrimidine derivatives based on thestructures of 3′-deoxythymidine, 3′-deoxyuridine, 3′-deoxycytidine,3′-thiacytidine, their stereoisomers, their modified forms withsubstitutions at positions 5, 6, and substitutions at positions 1′, 2′,3′, 4′, and 5′ of carbohydrate moiety, purine nucleosides based on thestructures of 3′-deoxyguanidine, 3′-deoxyadenosine, their modified formswith substitutions at positions 2, 4, 6, 8, and/or N4 of base moiety,substitutions at positions 1′, 2′, 3′, 4′, and 5′ of carbohydratemoiety, and/or double bond between C3′ and C4′ in carbohydrate moiety(FIG. 3).

In one aspect, the invention provides methods of synthesis for theabove-mentioned analogues using conjugation strategies which employappropriate coupling reagents and linkers (Agarwal et al., 1990; Paranget al., 1998; Torrence et al., 1993; Palomino et al, 1989; Chu et al,1990; Seki et al., 1990; Gao et al., 1999; Vlieghe et al., 2002). Thesemethods include acylation of appropriately protected nucleosides withfatty acyl chloride in the presence of 4-(dimethylamino)pyridine (DMAP).In another strategy, appropriate bifunctional linkers are conjugatedfirst with appropriately protected nucleosides, followed by secondcoupling reaction with fatty acids analogues or polyanionic compounds.In another strategy, appropriate bifunctional linkers are firstconjugated with fatty acids or polyanionic compounds, followed by secondcoupling reaction with appropriately protected nucleosides (FIG. 4).When required nucleosides are protected with appropriate protectinggroups, such as DMTr for protection of amino groups ortert-butyldimethylsilyl (TBDMS) for protection of hydroxyl groups.

For example, for the synthesis of fatty acyl substituted analogues oflamivudine, 5′-hydroxyl group was first protected with TBDMS in thepresence of tert-butyldimethylsilyl chloride (TBDMS-Cl), imidazole indry DMF to afford 5′-t-butyldimethylsilyl lamivudine. N4 substitutedanalogues were synthesized by acylation in the presence of fatty acylchloride and DMAP in dry benzene, followed by deprotection of TBDMSgroup with tert-butylammonium fluoride (TBAF). For the synthesis of5′-O-fatty acyl derivatives of lamivudine after initial protection of5′-OH of lamivudine with TBDMS, the protection of N4-amino group of5′-protected lamivudine was carried out in the presence of DMTr-Cl indry pyridine to afford N-DMTr-5′-t-butyldimethylsilyl lamivudine. Thedeprotection of TBDMS in the presence of TBAF, followed byesterification of 5′-hydroxyl group in the presence of fatty acids, HBTUand N-methylmorpholine (NMM) afforded 5′-O-fatty acyl-N-4-DMTrderivative of lamivudine. The final deprotection of DMTr wasaccomplished with acetic acid to afford 5′-O-fatty acyl derivatives oflamivudine. Disubstituted derivatives of lamivudine were synthesized bythe reaction of lamivudine with fatty acyl chlorides in anhydrousbenzene in the presence of DMAP (FIG. 5). A similar strategy was usedfor the synthesis of ′-substituted analogues of emtricitabine.5′-Substituted analogues of stavudine, AZT, and FLT were synthesized bythe reaction of the nucleosides with prepared fatty acyl chlorides indry benzene in the presence of DMAP.

In another aspect, these analogues are fatty acid derivatives, fattyalcohol derivatives, or polyanionic derivatives of3′-azido-3′-deoxythymidine (zidovudine, AZT),3′-fluoro-3′-deoxythymidine, 2′,3′-dideoxy-3′-thiacytidine (lamivudine,3TC), 2′,3′-didehydro-2′,3′-dideoxythymidine (stavudine, 4dT),2′,3′-dideoxycytidine (zalcitabine, ddC), and(−)-β-2′,3-dideoxy-5-fluoro-3′-thiacytidine (emtricitabine, FTC).However, those skilled in the art will recognize that these fatty acidanalogues may be derivatized from any suitable nucleoside conjugatedwith these fatty acid or polyanionic analogues.

It is a further object of this invention to describe the synthesis ofpolyanionic derivative of nucleosides and biological activity of thenucleoside derivatives, chemically conjugated or linked, directly orindirectly, to other compounds such as cellulose sulfate and suramin(FIGS. 6-8). In one strategy, appropriate bifunctional linkers areconjugated first with appropriately protected nucleosides, followed by asecond coupling reaction with polyanionic compounds.

For example, AZT-succinic acid conjugate was reacted with sodiumcellulose sulfate in the presence of PPh₃ and DIAD to produceAZT-succinic-sodium cellulose sulfate conjugate (FIG. 6). Similarly,FLT-succinic acid was reacted with sodium cellulose sulfate in thepresence of DIC, DMAP, and DIPEA (FIG. 7). Suramin was reacted directlywith AZT and FLT in the presence of P₂O₅ in DMF to afford suramin-AZTand suramin-FLT conjugates, respectively (FIG. 8).

In another strategy, appropriate bifunctional linkers are firstconjugated with polyanionic compounds, followed by second couplingreaction with appropriately protected nucleosides.

Linkers are known to those skilled in the art. The flexible or rigidlinkers may be alkyl and/or aryl chains with different lengths,phosphoglycerate, phosphoramidate, phosphomonoester, phosphodiester,phosphotriester, tiglycerides, cyclic phosphotriesters, cyclic phosphitetriesters, 2-hydroxybenzyl alcohol, cycloSaligenyl groups, acetate,dicarboxylic acid esters (—OOC—(CH₂)_(n)—COO—, n=0-14 such assuccinate), L or D-amino acyl (—NH—(CHR)_(n)—CO—, R═H or side chains ofamino acids, n=1-25 such as γ-aminobutyric acid, glutamic acid, asparticacid, serine, threonine forming linear or cyclic peptides), polyethers(e.g., ethylene glycol ethers (—OCH₂CH₂O)_(n)—, n=1-14), carboxylic acidesters ethers (—OOC—(CH₂)_(n)—CH₂)_(n)—CH₂O—, n=0-14), polyamides, orany combination of the linkers (e.g.,—OOC(CH₂)_(n)CONH(CH₂CH₂O)_(n)NHCO(CH₂)_(n)COO—). Exemplary linkers areshown in FIG. 9.

Scaffolds are known to those skilled in the art. The scaffolds may bederivatives containing one to three 2-hydroxybenzyl alcohol (e.g.,4,4′-dihydroxy-3,3′-di-(hydroxymethyl)diphenylmethane,4,6-dihydroxy-1,3-benznedimethanol,4,4′,4″-methanetriyltris(2-(hydroxymethyl)phenol)), polycarboxylic acids(e.g. tribenzenetriacetic acid, hydroxybenzendicarboxylic acid,[(hydroxyphenylene)dixoy]diacetic acid, tris(carboxymethoxy)benzene, andtriazine-tricarboxylic acid derivatives, such as(triazinetriyltroxy)triacetic acid and1,3,5-triazine-2,4,6-tricarboxylic acid), and anionic polymers(cellulose sulfate, cellulose sulfate acetate, dextran sulfate,naphthalene sulfonate derivatives, polystyrene sulfonate, carrageenans,polycarboxylic acid, polyvinylpyrrolidone, or cyclodextrin sulfate, andwhere other polyanionic compounds are polyphosphorylated polymers,suramin, or multisulfated and multiphosphorylated peptides and alkylchains). Exemplary scaffolds are shown in FIG. 9.

In contact with cells, the linkers are cleaved and the two componentsare separated. In the case of large anionic polymers such as cellulosesulfate, this compound remains outside the cells inhibiting HIV cellentry, while the nucleoside derivative is rapidly taken up, inhibitingHIV reverse transcriptase and replication.

In one aspect, this invention provides examples of antiviral activity ofsome of the fatty acid analogues against HIV-1, cell-free andcell-associated, X4 and R5 variants (Table 1). Some of the discoveredanalogues exhibit higher antiviral activity than their parentnucleosides.

Most of the derivatives are more potent than AZT.2′,3′-Dideoxy-5-fluoro-3′-thiacytidine derivatives are the most potentcompounds and their activities were significantly higher than physicalmixtures of the corresponding compounds. Furthermore,3′-fluoro-2′,3′-dideoxythymidine derivatives are also potent and show nosigns of cytotoxicity against Hela cells, peripheral blood mononuclearcells and human vaginal cells (FIGS. 10 and 11). Unlike AZT, they didnot show a drop in potency against multidrug resistant virus (Table 2)and are highly active against cell-associated virus. In general, fattyester conjugates of FLT performed much better against cell-associatedHIV compared to the corresponding physical mixtures.

Ether derivatives of FLT and AZT substituted with 5′-tetradecanol (FIG.12) were significantly less potent than the corresponding esterderivatives (Table 1). These data demonstrate that the ester bonds areimportant in enabling anti-HIV activity. The ester needs to behydrolyzed rendering parent nucleosides and fatty acids for the compoundto display antiviral activity. In ether derivatives, the hydrolysis isnot possible because the ether bond is not susceptible to the cleavageaction of esterases.

Unexpectedly, FLT derivatives were found to inhibit growth andmultiplication of H. ducreyi, a bacterium known to cause chancroid andbe a risk factor for acquisition of HIV infection (Table 3). Certainfatty acid substituted nucleoside derivatives display anti-microbialactivity against sexually transmitted pathogens other than HIV.

In another aspect, this invention provides the synthesis and evaluationof 5(6)-carboxyfluorescein (FAM) derivatives of nucleosides. Forexample, FLT was attached to 5(6)-carboxyfluorescein using β-alanine and12-aminododecanoic acid as linkers. First, FLT was reacted with thecorresponding Fmoc-amino acid in presence of HBTU and DIPEA. Second,N-Fmoc deprotection to free amino group was achieved in the presence ofpiperidine. Finally, FAM was attached to free amino group in thepresence of HBTU and DIPEA to afford 5(6)-carboxyfluorescein derivativesof FLT, KPH-1.5 and KPH-1.6 (FIG. 13). Similarly, FAM derivatives of 3TCwere synthesized. These compounds were used for cellular uptake studiesto determine cellular uptake profile of fatty acyl ester derivatives ofFLT, 3TC, and other nucleosides. FLT attached to FAM through (3-Alanine(KPH-1.5) was used as a control FLT analogue. FLT attached to FAMthrough 12-aminododecanoic acid (KPH-1.6) was used as an analogue of3′-fluoro-2′,3′-dideoxy-5′-O-(12-azidododecanoyl)thymidine (KP-1) andother fatty acid ester analogues of FLT.3′-Fluoro-2′,3′-dideoxy-5′-O-(12-aminododecanoyl)thymidine and showedanti-HIV activities comparable to other fatty acyl derivatives of FLT.KPH-1.6(3′-fluoro-2′,3′-dideoxy-5′-O-(12-(N-5(6)carboxylfluoresceinaminododecanoyl)thymidine)showed slightly lower anti-HIV activity when compared with unsubstituted12-aminododecanoyl derivative (Table 1).

The human T lymphoblastoid cells CCRF-CEM (ATCC no. CCL-119) were usedfor the study and were grown to the 70% confluency in the culture media.Cells were incubated with the fluorescein-substituted conjugates(KPH-1.5 and KPH-1.6) in different time periods, concentrations and inthe presence or absence of with trypsin, DMSO and FAM were used ascontrol for the study. The cells were analyzed by flow cytometry(FACSCalibur: Becton Dickinson) using FITC channel and CellQuestsoftware. The data presented are based on the mean fluorescence signalfor 10000 cells collected. All the assays were carried out intriplicate.

Cells were incubated with 10 μM of the compounds in different timeperiods (0.5 h, 1 h, 2 h, 4 h and 8 h, FIG. 14). KPH-1.6 exhibited 10-15fold higher cellular uptake than that of KPH-1.5 and FAM alone. Theresults clearly indicate that presence of long chain enhances thecellular uptake of FLT, by increasing lipophilicity. The continuousincubation of cells with compounds up to 8 h did not show significantdifference in the cellular uptake, suggesting that most of the fattyacyl ester derivative is absorbed into cells in the first 30 minutes andthe cellular uptake was not time dependent.

Cells were also incubated with different concentrations (5, 10, 20, 40and 100 μM) of carboxyfluorescein derivatives of FLT, KPH-1.5 andKPH-1.6 for 1 h (FIG. 15), and data suggest that the cellular uptake isconcentration dependent.

To confirm that the enhanced uptake of 5(6)-carboxyfluoresceinderivatives of FLT, KPH-1.6, is not due to the absorption on the cellmembrane surface, cells were incubated with 10 μM of DMSO, FAM, KPH-1.5and KPH-1.6 for 1 h and then finally treated with trypsin for 5 min towash the adsorbed molecules (if any) from the cell membrane. Thecellular uptake studies after trypsin treatment showed that the cellularuptake of KPH-1.6 was still much higher than those of control compounds,FAM and KPH-1.5 (FIG. 16), suggesting that the higher cellular uptake ofKPH-1.6 is not due to absorption to the cell membrane.

Cells were incubated with 10 μM of DMSO, FAM, KPH-1.5 and KPH-1.6 for 1h and then imaged using a light microscope (ZEISS Axioplan 2) equippedwith transmitted light microscopy with a differential-interferencecontrast method and an Achroplan 40× objective. Cells showed nosignificant fluorescence when incubated with DMSO, FAM, and KPH-1.5(FIG. 17). On the other hand, cells incubated with KPH-1.6 showedfluorescence. The results further confirm the higher cellular uptake ofKPH-1.6, a fatty acyl derivative of FLT, in comparison to KPH-1.5 andFAM alone. Similar results were also observed withfluorescein-substituted derivative of 3TC. These data indicate that thefatty acyl derivatives of nucleosides have better cellular uptake thantheir parent nucleosides.

Polyanionic conjugates exhibit multiple mechanisms of action, whichresult in synergistic or additive activity. For example, a CS-AZTconjugate (acetate linker; 1.73% loading) was more effective than CS,especially against the R5 HIV-1 lab-adapted strain BaL. Sodium cellulosesulfate-acetate exhibited significantly higher potency than sodiumcellulose sulfate against cell-free virus. Sodium cellulosesulfate-acetate conjugated with AZT (1.73%) and the physical mixture ofsodium cellulose sulfate-acetate with AZT (1.73%) displayed a higheranti-HIV activity in cell-free virus when compared to sodium cellulosesulfate, sodium cellulose sulfate-succinate-AZT (17.2%), and thephysical mixture of sodium cellulose sulfate and AZT (1.73%). Similarly,Sodium cellulose sulfate-acetate-FLT and the physical mixture of sodiumcellulose sulfate-acetate and FLT showed better anti-HIV profile thansodium cellulose sulfate and the mixture of sodium cellulose sulfate andFLT (Table 4). The presence of acetate linker on sodium cellulosesulfate improves the inhibition, possibly by creating new negativecharges after hydrolysis of the sodium cellulose sulfate-Acetate-AZT orsodium cellulose sulfate-Acetate-FLT (Table 4).

These conjugates are especially suited for topical microbicidalapplications. Cellulose sulfate and other polyanions such ascarrageenan, carbopol and naphthalene polymers are currently undergoingor have recently completed clinical efficacy trials for prevention ofsexual transmission of HIV. Most of these compounds, however, have shownweak(er) activity against R5HIV-1 viruses (Dezutti et al, 2004; Moulardet al, 2000). The CS-AZT conjugate also was more effective than AZTagainst both X4 and R5HIV-1 viruses. Furthermore, the above-describedconjugates present the advantage of not displaying weaker activityagainst HIV R5 strains (Table 5). Although in weight the conjugate andAZT were similarly potent against cell-free virus, in moles (based on CS˜2×10⁶ Daltons), the conjugate was 5 orders of magnitude more potent(from μM to subnanomolar). Furthermore, unlike AZT, the conjugate wasconsistently active against cell-associated HIV.

Substitution of suramin with AZT or FLT improves the anti-HIV activityof suramin by 2-2.5 fold. Furthermore, the physical mixture of suraminand FLT or AZT is at least 55 fold more potent against HIV-1 IIIB thansuramin alone, suggesting a positive combinatorial effect (Table 6).

The present invention provides methods of treating, preventing, orreducing transmission of sexually transmitted pathogens. Non-limitingexamples of sexually transmitted pathogens include: humanimmunodeficiency virus (HIV), herpes simplex virus (HSV), humanpapilloma virus (HPV), Chlamydia trachomatis (CT), Neisseria gonorrhoeae(NG), and Haemophilus ducreyi (HD). The methods of the present inventioncomprise administering to a person in need of a therapeuticallyeffective amount of the compounds of the present invention or apharmaceutically acceptable salt thereof.

The compounds of the present invention may be formulated in a widevariety of administration dosage forms and carriers. Topicaladministration can be delivered vaginally, anally, rectally, over thepenis, or over other areas of the body. Oral administration can be inthe form of tablets, coated tablets, dragees, hard and soft gelatinecapsules, solutions, emulsions, syrups, or suspensions. Compounds of thepresent invention are efficacious when administered by other routes ofadministration including continuous (intravenous drip), parenteral,intramuscular, intravenous, subcutaneous, transdermal (which may includea penetration enhancement agent), buccal, nasal, inhalation andsuppository administration, among other routes of administration.

In another aspect, this invention provides the composition of matter andthe use of the above-described derivatives and conjugates as topicalmicrobicides to treat or prevent sexual transmission of disease,especially HIV/AIDS, chancroid, gonorrhea and chlamydia, herpes andpapillomavirus infections.

The compounds of the present invention, as well as theirpharmaceutically useable salts, together with one or more conventionalexcipients, carriers, or diluents, may be placed into the form ofpharmaceutical compositions and unit dosages. The pharmaceuticalcompositions and unit dosage forms may be comprised of conventionalingredients in conventional proportions, with or without additionalactive compounds or principles, and the unit dosage forms may containany suitable effective amount of the active ingredient commensurate withthe intended daily dosage range to be employed. The pharmaceuticalcompositions may be employed as solids, such as tablets, films or filledcapsules, semisolids, powders, sustained release formulations, orliquids such as solutions, suspensions, emulsions, elixirs, or filledcapsules for oral use; or in the form of suppositories for rectal orvaginal administration; or in the form of sterile injectable solutionsfor parenteral use.

A typical preparation contains from about 0.01% to about 99% activecompound or compounds (w/w). In one embodiment of the present invention,the preparation contains from about 0.1% to about 10% active compound orcompounds (w/w). The term “preparation” or “dosage form” is intended toinclude different formulations of the active compound and one skilled inthe art will appreciate that an active ingredient can exist in differentpreparations depending on the target organ or tissue and on the desireddose and pharmacokinetic parameters.

Solid form preparations include powders, tablets, films, pills,capsules, cachets, suppositories, and dispersible granules. A solidcarrier may be one or more substances which may also act as diluents,flavoring agents, solubilizers, lubricants, suspending agents, binders,preservatives, tablet disintegrating agents, or an encapsulatingmaterial. In powders, the carrier generally is a finely divided solidwhich is a mixture with the finely divided active component. In tablets,the active component generally is mixed with the carrier having thenecessary binding capacity in suitable proportions and compacted in theshape and size desired. Suitable carriers include but are not limited tomagnesium carbonate, magnesium stearate, talc, sugar, lactose, pectin,dextrin, starch, gelatin, tragacanth, methylcellulose, sodiumcarboxymethylcellulose, a low melting wax, cocoa butter, and the like.Solid form preparations may contain, in addition to the activecomponent, colorants, flavors, stabilizers, buffers, artificial andnatural sweeteners, dispersants, thickeners, solubilizing agents, andthe like.

Liquid formulations also are suitable for oral administration includeliquid formulation including emulsions, syrups, elixirs, aqueoussolutions, and aqueous suspensions. These include solid formpreparations which are intended to be converted to liquid formpreparations shortly before use. Emulsions may be prepared in solutions,for example, in aqueous propylene glycol solutions or may containemulsifying agents such as lecithin, sorbitan monooleate, or acacia.Aqueous solutions can be prepared by dissolving the active component inwater and adding suitable colorants, flavors, stabilizing, andthickening agents. Aqueous suspensions can be prepared by dispersing thefinely divided active component in water with viscous material, such asnatural or synthetic gums, resins, methylcellulose, sodiumcarboxymethylcellulose, and other well known suspending agents.

The compounds of the present invention may be formulated foradministration as suppositories. A low melting wax, such as a mixture offatty acid glycerides or cocoa butter is first melted and the activecomponent is dispersed homogeneously, for example, by stirring. Themolten homogeneous mixture is then poured into convenient sized molds,allowed to cool, and to solidify. The compounds of the present inventionmay also be formulated for vaginal administration. Pessaries, tampons,creams, gels, pastes, foams or sprays containing in addition to theactive ingredient such carriers as are known in the art to beappropriate. When desired, formulations can be prepared with entericcoatings adapted for sustained or controlled release administration ofthe active ingredient.

Suitable formulations along with pharmaceutical carriers, diluents andexcipients are described in Remington: The Science and Practice ofPharmacy 1995, edited by E. W. Martin, Mack Publishing Company, 19thedition, Easton, Pa. A skilled formulation scientist may modify theformulations within the teachings of the specification to providenumerous formulations for a particular route of administration withoutrendering the compositions of the present invention unstable orcompromising their therapeutic activity. All these formulations willcontain the amounts of preservatives, such as methyl paraben, propylparaben benzyl alcohol, benzoic acid, or ascorbic acid, needed toprevent microbial growth.

The term “therapeutically effective amount” as used herein means anamount required to reduce symptoms of the disease in an individual or toprevent primary HIV infections. The dose may be adjusted to theindividual requirements in each particular case. That dosage can varywithin wide limits depending upon numerous factors such as the severityof the disease to be treated, the age and general health condition ofthe patient, other medicaments with which the person is being treated,the route and form of administration and the preferences and experienceof the medical practitioner involved. One of ordinary skill in treatingdiseases described herein will be able, without undue experimentationand in reliance on personal knowledge, experience and the disclosures ofthis application, to ascertain a therapeutically effective amount of thecompounds of the present invention for a given disease and patient. Forprevention purposes, however, the dosage is likely to be fixed.

In one aspect, the nucleoside analogues and conjugates may be dissolvedor dispersed in a number of carriers. For example, it may be formulatedfor “stand alone” usage in forms which include but are not limited togels, foams, suppositories, creams, lotions, tablets, films, pessariesand the like. Many suitable carriers exist which are well known to thoseof skill in the art and which may be used in the practice of the presentinvention. The use of all such carriers is meant to be encompassed bythe present invention.

The formulations may further include other ingredients, which are wellknown to those of skill in the art, including but not limited tostabilizers, colorants, preservatives, perfumes, gelling agents,antioxidants, other active ingredients and the like. The composition ofmatter of the present invention may contain one or a plurality ofnucleoside analogues described above.

In another aspect, the nucleoside analogues and conjugates may bedelivered by delivery systems such as rings, rods, diaphragms and othercervicovaginal and rectal devices. Their release may be controlled bythe material composing these devices, such as silicone elastomers,ethylene vinyl acetate and polyurethane polymers.

The composition of matter of the present invention may also be used inconjunction with other contraceptive devices. Examples include, but arenot limited to, addition to condoms or diaphragms to enhance theiractivity, or to imbibe a cervico-vaginal sponge that would act as both amechanical and chemical barrier against sperm and microbicides. Thecomposition of matter may be delivered by a cervical/vaginal device.

In another aspect, the present invention also provides a method ofcontraception in female mammals, which involves placing acontraceptively effective amount of a spermicidal analogue or conjugatein the vaginal cavity of a female mammal (Table 7). Those of skill inthe art will recognize that a variety of means are known by which acompound may be delivered intravaginally, for example, plunger-typeapplicators, pessaries, tablets, sprays, squeezable tubes, cervicalrings, sponges, films and the like. All such means for intravaginaldelivery are intended to be encompassed by the present invention. In apreferred embodiment, such conjugates contain cellulose sulfate,polycarboxylic acid or suramin.

In another aspect, the present invention provides methods of synthesisand possible applications of peptide derivatives containing one to threenucleosides with or without myristic acid analogues (FIGS. 18 and 19).Examples of synthesis of some compounds are given here.

Peptide-nucleoside conjugates containing one nucleoside and myristicacid were synthesized by solid-phase synthesis. For the synthesis ofKPH-94 and KPH-95, first Fmoc-Glu(nucleoside)-OH was synthesized as thebuilding block. The reaction of Fmoc-Glu(OH)-tBu with nucleoside in thepresence of HBTU and DIPEA, followed by the deprotection of tBu groupwith TFA afforded the corresponding Fmoc-Glu(nucleoside)-OH.Fmoc-Ser(OMys)OH, a fatty acid building block, was synthesized by thereaction of Fmoc-Ser(OH)—OH with myristoyl chloride in the presence ofDIPEA. Solid-phase reaction of building blocks on Fmoc-Gly-Wang resin,followed by cleavage affordedmyristoylserine-nucleoside(glutamyl)glycine derivatives (KPH-94 andKPH-95) (FIG. 20).

Fmoc-solid-phase peptide protocol was used for the synthesis of KPH-92and KPH 93 by using Fmoc-Lys-4-methyltrityl (Mtt)-Wang resin,appropriate Fmoc-13Ala-OH, Fmoc-Glu(OFLT), acetic anhydride, andmyristic anhydride (FIG. 21).

The synthesis of peptides containing two nucleosides and myristate(KPH-97, KPH-99, KPH-910) or acetate (KPH-96, KPH-98, KPH-911) esterswas accomplished by the reaction of an appropriate building block, suchas Fmoc-Glu(FLT)-OH or Fmoc-Glu(AZT)-OH, with 3TC-DMTr or AZT in thepresence of DIPEA, followed by the deprotection of Fmoc group withpiperidine and 1-octanethiol, coupling reaction with myristic anhydrideor acetic anhydride in the presence of DIPEA, and deprotection of DMTrgroup with acetic acid (FIGS. 22-24).

For the synthesis of the peptide-containing three nucleosides andmyristate ester, NH₂-Glu(AZT)-3TC-DMTr was first reacted withFLT-succinate in the presence of DIPEA followed by acetic acid cleavageto afford KPH-914 (FIG. 24).

Peptides conjugated with fatty acids and nucleosides exhibited higheranti-HIV activities when compared with those substituted only withnucleosides. Increasing the number of anti-HIV nucleosides to 2 or 3 onthe peptide chain enhanced the anti-HIV potency. Physical mixtures ofnucleosides with amino acids and fatty acids used in the conjugationalso showed significantly higher potency. The presence of one myristicacid in the conjugates or physical mixtures improved the anti-HIVactivity, but addition of two myristic acids to the conjugates was notbeneficial (Table 8).

In another aspect, two anti-HIV nucleosides are linked together throughdifferent linkers, such as succinate and suberate. Nucleosidemonosuccinates were synthesized from the reaction of nucleosides (e.g.,AZT, FLT, 3TC) with succinic anhydride in the presence of pyridine.Nucleoside succinate in DMF was subjected to reaction with the secondnucleoside in the presence of HBTU and DIPEA to afford unsymmetricalnucleoside-nucleoside succinate derivatives (FIG. 25). Furthermore,reaction of nucleosides with succinyl chloride in the presence of DMAPor suberic acid in the presence of HBTU and DIPEA afforded symmetricalnucleoside-nucleoside derivatives (FIG. 26).

In another aspect, two or three anti-HIV nucleosides are linked togetherthrough two or three cycloSaligenyl groups substituted on a multivalentligand. For example,4,4′-dihydroxy-3,3′-di-(hydroxymethyl)diphenylmethane was reacted withphosphorus trichloride in the presence of 2,6-lutidine. The intermediatewas reacted with the first nucleoside, diisopropylphosphoramidousdichloride, and the second nucleoside, respectively. Oxidation reactionafforded dinucleoside dicycloSaligenyl nucleotides (FIG. 27). A similarstrategy was used using other multivalent ligands,4,6-dihydroxy-1,3-benznedimethanol (FIG. 28) and4,4′,4″-methanetriyltris(2-(hydroxymethyl)phenol) (FIG. 29).

In another aspect, two or three anti-HIV nucleosides are linked togetherthrough polycarboxylic acids (e.g. tribenzenetriacetic acid,hydroxybenzendicarboxylic acid, [(hydroxyphenylene)dixoy]diacetic acid,tris(carboxymethoxy)benzene, and triazine-tricarboxylic acidderivatives, such as (triazinetriyltroxy)triacetic acid and1,3,5-triazine-2,4,6-tricarboxylic acid). For example, tricarboxylicacid derivatives were reacted with three nucleosides, respectively, inthe presence of a base (e.g., DMAP) and oxalyl chloride to affordtricarboxylic acid derivative substituted with three nucleosides (FIG.30). Similarly, hydroxydicarboxylic derivatives were substituted withfirst fatty acid analog and then two nucleosides or two nucleosidesfirst and then with fatty acid analog to produce fatty acid-dinucleosideconjugates (FIG. 30). Appropriate protecting groups for protection ofphenol or carboxylic acid groups were used in this sequence.

The present invention also provides a method of neutralizing viralinfection, which comprises contact target cells, or overlayingepithelium with a quantity of a compound described above sufficient toneutralize the infection. In a preferred embodiment of the presentinvention, the virus is HIV.

The present invention also provides a method of inhibiting the growth ofa microbe, which comprises contacting the microbe with a quantity of acompound described above sufficient to inhibit the growth of themicrobe. Examples of microbes whose growth may be inhibited by themethod of the present invention include but are not limited to viruses,bacteria, protozoa, fungi and parasites.

While the invention has been illustrated and described in the figuresand foregoing description, the same is to be considered as illustrativeand not restrictive in character, it being understood that only thepreferred embodiments have been shown and described and that all changesand modifications that come within the spirit of the invention aredesired to be protected. In addition, all references and patents citedherein are indicative of the level of skill in the art and herebyincorporated by reference in their entirety.

TABLE 1 Anti HIV-1 Activity of Fatty Acid Substituted NucleosideDerivatives Cell-Associated Cell-Free Virus Virus Compound Name IIIB BaLSupT1 (IIIB) 3′-azido-2′,3′-dideoxythymidine (AZT) 9.2 0.8 >1003′-azido-2′,3′-dideoxy-5′-O-(9-thiatertradecanoyl)thymidine 3.7 8.1 (42.0 3′-azido-2′,3′-dideoxy-5′-O-(11- 3.8 2.6 44.9thioethylundecanoyl)thymidine3′-azido-2′,3′-dideoxy-5′-O-(12-bromododecanoyl)thymidine 5.6 2.6 >1003′-azido-2′,3′-dideoxythymidine (AZT) + 12- 19 4.8 >100 bromododecanoicacid 3′-azido-2′,3′-dideoxy-5′-O-(tetradecanoyl)thymidine 1.5 2.4 >1003′-azido-2′,3′-dideoxy-5′-O-(tetradecyl)thymidine (ether 57.8 12.8 >100derivative) 3′-azido-2′,3′-dideoxythymidine (AZT) + tetradecanoic acid)0.7 22.9 >100 3′-azido-2′,3′-dideoxy-5′-O-(pentadecanoyl)thymidine 8.82.2 >100 3′-fluoro-2′,3′-deoxythymidine (FLT) 0.2 0.1 >1003′-fluoro-2′,3′-dideoxy-5′-O-(12-bromododecanoyl)thymidine 0.9 <0.1 >1003′-fluoro-2′,3′-dideoxy-5′-O-(9-thiatertradecanoyl)thymidine 5.42.1 >100 3′-fluoro-2′,3′-dideoxy-5′-O-(2- 0.5 0.1 >100methoxytetradecanoyl)thymidine3′-fluoro-2′,3′-dideoxy-5′-O-(12-azidododecanoyl)thymidine 0.4 0.2 5.93′-fluoro-2′,3′-dideoxy-5′-O-(tetradecanoyl)thymidine 0.3 0.5 2.93′-fluoro-2′,3′-dideoxy-5′-O-(tetradecyl)thymidine (ether 79.1 77.3 >100derivative) 3′-fluoro-2′,3′-dideoxythymidine (AZT) + tetradecanoic acid)0.1 0.4 15.63′-fluoro-2′,3′-dideoxy-5′-O-(13-thiapentadecanoyl)thymidine 0.5 <0.11.1 3′-fluoro-2′,3′-dideoxy-5′-O-(12-aminododecanoyl)thymidine 0.673′-fluoro-2′,3′-dideoxy-5′-O-(12-(N- 4.35(6)carboxylfluoresceinaminododecanoyl)thymidine2′,3′-dideoxy-3′-thiacytidine (lamivudine, 3TC) 7.5 2.6 18.4 N4,5′-O-dimyristoyl-2′,3′-dideoxy-3′-thiacytidine >100 87.8 >100 N4,5′-O-di(12-azidodecanoyl)-2′,3′-dideoxy-3′-thiacytidine >100 49.1 >100N4-tetradecanoyl-2′,3′-dideoxy-3′-thiacytidine 4.8 0.3 0.3N4-(12-azidodecanoyl)-2′,3′-dideoxy-3′-thiacytidine 13.3 1.7 6.6N4-(13-thiapentadecanoyl)-2′,3′-dideoxy-3′-thiacytidine 2.5 0.2 >1005′-O-tetradecanoyl-2′,3′-dideoxy-3′-thiacytidine 0.3 0.082 27.35′-O-(12-azidododecanoyl)-2′,3′-dideoxy-3′-thiacytidine 0.88 0.08 >1005′-O-(13-thiapentadecanoyl)-2′,3′-dideoxy-3′-thiacytidine 1.1 <0.1 >1002′,3′-didehydro-2′,3′-dideoxythymidine (d4T) 6.0 6.3 30.55′-O-myristoyl-2′,3′-didehydro-2′,3′-dideoxythymidine 34 5.4 >1005′-O-(12-azidodecanoyl)-2′,3′-didehydro-2′,3′-dideoxythymidine 3.0 1.410.0 5′-O-(12-thioethylazidodecanoyl)-2′,3′-didehydro-2′,3′- 6.7 2.721.7 dideoxythymidine12-bromododecanoyl-2′,3′-didehydro-2′,3′-dideoxythymidine 7.2 1.1 >1002′,3′-dideoxy-5-fluoro-3′-thiacytidine (emtricitabine, FTC) 0.48 0.1821.9 5′-O-(12-azidododecanoyl)-2′,3′-dideoxy-5-fluoro-3′-thiacytidine0.39 0.11 4.3 5′-O-tetradecanoyl-2′,3′-dideoxy-5-fluoro-3′-thiacytidine0.056 0.033 1.75′-O-(13-thiapentadecanoyl)-2′,3′-dideoxy-5-fluoro-3′-thiacytidine 0.0240.02 2.4 2′,3′-dideoxy-5-fluoro-3′-thiacytidine (emtricitabine, FTC) +0.6 0.1 9.9 myristic acid 2′,3′-dideoxy-5-fluoro-3′-thiacytidine(emtricitabine, FTC) + 12- 0.1 0.2 9.8 thioethydodecanoic acid(13-thiapentadecanoic acid) Data represent IC₅₀ (50% inhibitoryconcentration) and are expressed in μg/mL. Single-round infection assaywhere compounds, virus and cells were incubated for 2 hours. Cells werethen washed and cultured for additional 48 h. Infection was measured byHIV-LTR driven Galactosidase expression.

TABLE 2 Antiviral Activity against multidrug resistant HIV IC₅₀ CompoundName Type of Virus (μg/mL) 3′-azido-2′,3′-dideoxythymidine R5 0.02 (AZT)MDR 0.33 3′-fluoro-2′,3′-dideoxy-5′-O-(12- R5 0.003azidododecanoyl)thymidine MDR 0.003 3′-fluoro-2′,3′-dideoxy-5′-O- R50.003 (tetradecanoyl)thymidine MDR 0.0023′-fluoro-2′,3′-dideoxy-5′-O-(13- R5 0.002 thiapentadecanoyl)thymidineMDR 0.002 IC₅₀ = The minimum drug concentration that inhibitsHIV-induced cytopathic effect by 50%, calculated by using a regressionanalysis program for semilog curve fitting. Assay endpoint = RT activityHIV-1 clinical isolates: R5 = 92TH014; MDR = Multidrug resistant virus7324-1. Assay endpoint = RT level. Compound-virus-cell incubation = 6 h.After removing supernatant, cells were further incubated for 6 days.

TABLE 3 Antibacterial Activity against Haemophilus ducreyi H. ducreyiStrain Compound Name HMC56 HMC 62 HMC 64 3′-fluoro-2′,3′-dideoxy-5′- 125125 125 O-(13-thiapentadecanoyl)thymidine 3′-fluoro-2′,3′-dideoxy-5′-500 125 125 O-(12-azidododecanoyl)thymidine 3′-azido-2′,3′-dideoxy-5′-250 250 750 O-(9-thiatertradecanoyl)thymidine3′-azido-2′,3′-dideoxythymidine (AZT) 125 750 500 Data represent MIC(minimum inhibitory concentration) and are expressed in μg/mL

TABLE 4 Anti HIV Activity of CelluloseSulfate-3′-Azido-2′,3′-dideoxythymidine and CelluloseSulfate-3′-Fluoro-2′,3′-dideoxythymidine Conjugates Cell-FreeCell-Associated Virus Virus Compound Chemical Name Cytotoxicity IIIB BaLSupT1-IIIB CS Sodium Cellulose Sulfate >100 5.9 62.5 2.5 CS-Ac SodiumCellulose Sulfate-Acetate >100 1.27 1.81 6.57 AZT3′-azido-2′,3′-dideoxythymidine >100 2.4 4.2 >100 CS-Ac-AZT SodiumCellulose Sulfate-Acetate-AZT >100 2.5 8.1 5.6 (1.73%) CS-Ac + Sodiumcellulose sulfate-Acetate + AZT >100 1.7 2.5 8.0 AZT (1.73%) CS-Suc-Sodium cellulose sulfate-succinate-AZT >100 2.2 9.9 74.8 AZT (17.2%)CS + AZT Sodium cellulose sulfate + AZT (1.73%) >100 16.2 15.3 7.6CS-Ac-FLT Sodium Cellulose Sulfate-Acetate-FLT >100 2.3 1.5 5.8 (1.45%)CS-Ac + Sodium cellulose sulfate-Acetate + FLT >100 0.72 0.31 4.72 FLT(1.26%) CS + AZT Sodium cellulose sulfate + FLT (1.25%) >100 6.2 7.1 7.4Data represent EC₅₀ (50% effective concentration) and are expressed inμg/mL

TABLE 5 Antiviral Activity of 3′-Azido/3′-Fluoro-2′,3′-dideoxythymidine-Cellulose Sulfate Conjugates Against R5 and Multidrug Resistant HIV-1Clinical Isolates Compound Name Type of Virus IC₅₀ (μg/mL) CelluloseSulfate-Acetate- R5 3.52 AZT MDR 4.22 Cellulose Sulfate-Acetate-FLT R52.67 MDR 0.50 Cellulose Sulfate (CS) R5 >20.0 MDR 1.61 Dextran SulfateR5 15.7 MDR 3.12 Assay endpoint = p24 level (ELISA). Compound-virus-cellincubation = 6 h. After removing supernatant, cells were furtherincubated for 6 days. IC50 = The minimum drug concentration thatinhibits HIV-induced cytopathic effect by 50%, calculated by using aregression analysis program for semilog curve fitting HIV-1 clinicalisolates: R5 = 92TH014; MDR = Multidrug resistant virus 7324-1

TABLE 6 Anti HIV Activity of Suramin-3′-Azido-2′,3′-dideoxythymidine andSuramin-3′-Fluoro-2′,3′-dideoxythymidine Conjugates Cell-Free VirusCompound Chemical Name Cytotoxicity IIIB BaL Suramin Suramin >100 49.11.0 Suramin-AZT Suramin-3′-azido-2′,3′- >100 19.4 7.3 dideoxythymidineSuramin + Suramin + AZT (45:55) >100 0.9 1.4 AZT Suramin-FLTSuramin-3′-fluoro-2′,3′- >100 23.6 6.2 dideoxythymidine Suramin + FLTSuramin + FLT (47:53) >100 0.4 <0.1 Data represent EC₅₀ (50% effectiveconcentration) and are expressed in μg/mL

TABLE 7 Contraceptive efficacy of3′-Azido-2′,3′-dideoxythymidine-Cellulose Sulfate conjugateConcentration No. of Pregnant Pregnancy Group (mg/ml) females/total rate(%) TALP Control 4/4 100 CS 1 mg/ml 0/5 0 AZT-CS 1 mg/ml 0/5 0 Femalerabbits were inseminated with pooled rabbit semen containing 1 mg/mL oftest compound or medium control (TALP)

TABLE 8 Anti HIV Activity of Peptide Conjugates of Nucleosides with orwithout Fatty Acid Substitution Cell-free HIV-1 Cell-free HIV-1Cytotoxicity (IIIB) (IIIB) Compound Chemical Name μg/mL. μg/mL. μM3′-azido-2′,3′-dideoxythymidine >100 9.2 34.4 (AZT)3′-fluoro-2′,3′-deoxythymidine >100 0.2 0.8 (FLT)2′,3′-dideoxy-3′-thiacytidine >100 7.5 32.7 (lamivudine, 3TC) KPH-96FLT(Glutamyl)-3TC >100 10.7 17.1 KPH-97 FLT(mysristoylglutamyl-3TC >1001.6 2.0 KPH-921 FLT + 3TC + Glutamic acid >100 0.6 KPH-922 FLT + 3TC +Glutamic acid + >100 0.3 Myristic acid KPH-98 FLT(Glutamyl)-AZT >100 9.013.5 KPH-99 FLT(mysristoylglutamyl-AZT >100 2.0 2.4 KPH-923 FLT + AZT +Glutamic acid >100 1.0 KPH-924 FLT + AZT + Glutamic acid + >100 0.3Myristic acid KPH-911 AZT(Glutamyl)-3TC >100 7.8 12.0 KPH-910AZT(mysristoylglutamyl-3TC >100 4.9 6.0 KPH-919 AZT + 3TC + Glutamicacid >100 1.7 KPH-920 AZT + 3TC + Glutamic Acid + >100 1.9 Myristic AcidKPH-913 AZT-succinate-AZT >100 8.6 13.9 KPH-912 FLT-succinate-FLT >1002.1 3.7 KPH-914 FLT-Succinate-AZT(glutamyl)- >100 0.9 0.96 3TC KPH-928FLT-Succinate + AZT + 3TC + >100 1.8 Glutamic acid KPH-926 FLT + AZT +3TC + Glutamic >100 0.8 acid KPH-927 FLT + AZT + 3TC + glutamicacid + >100 0.3 Myristic acid KPH-91 FLT(Glutamyl)-myrsitoyllysine >1008.7 10.5 KPH-92 FLT(myristoylglutamyl)- >100 24.7 26.8 mysritoyllysineKPH-94 Myristoylserine-FLT(glutamyl) >100 9.3 11.1 glycine KPH-95Myristoylserine-AZT(glutamyl) >100 54.5 63.1 glycine Data represent EC₅₀(50% effective concentration). Single-round infection assay wherecompounds, virus and cells were incubated for 2 hours. Cells were thenwashed and cultured for additional 48 h. Infection was measured byHIV-LTR driven Galactosidase expression.

1. A compound comprising at least one substituted nucleoside selectedfrom the group consisting of Formulas I-VI:

wherein R₁=Z—CO—, anionic polymer, fatty acid analogue, or fatty alcoholanalogue complexed with a cleavable linker, or carboxylic ester sidechains of linear or cyclic peptides, polycarboxylic ester derivativeslike tricarboxylic acid derivatives of aromatics or heteroaromatics,carbopol, and phosphodiester derivatives; whereinZ=X(CH₂)_(n)Y(CH₂)_(n)—, CH₃(CH₂)_(n)CH(Br)—, suramin, celluloseacetate, or an anionic polymer; X═CH₃, N₃, alkyl-S, alkyl-O, aryl-O,aryl-S, alkyl-NH, arylNH, Br, Cl, F, I, OH, NH₂, COOH, CHO, CH₃S, aryl,heteroaryl, phenyl, substituted phenyl, alkyne, alkene, suramin,cellulose acetate, or an anionic polymer; Y═CH₂, O, S, NH,1,2,3-triazole; n=0-18; R₂═H, N₃, F, CN, Cl, Br, I, OH, NH₂, SH; R₃═H,Br, I, F, Cl, alkyl, alkene, alkyne, aryl, O-alkyl, O-aryl; R₄═H, Br, I,F, Cl, alkyl, alkene, alkyne, aryl, O-alkyl, O-aryl; and R₅═H or R₁. 2.The compound according to claim 1, wherein the nucleoside is apyrimidine or purine derivative.
 3. The compound according to claim 1,wherein the nucleoside is selected from the group consisting of3′-fluoro-2′,3′-deoxythymidine (FLT), 3′-azido-3′ deoxythymidine(zidovudine, AZT), 2′,3′-dideoxy-3′-thiacytidine (3TC),2′,3′-dideoxy-didehydro-2′,3′-deoxythymidine (d4T),2′,3′-dideoxycytidine (ddC), or(+(3-2′,3′-dideoxy-5-fluoro-3′-thiacytidine (FTC).
 4. The compoundaccording to claim 1 wherein the anionic polymer is selected from thegroup consisting of dextran sulfate and sodium cellulose sulfate. 5-26.(canceled)
 27. The compound according to claim 3, wherein thesubstituted nucleoside exhibits microbicide activity to treat infectionor prevent or reduce transmission of sexually transmitted pathogen. 28.The compound according to claim 27, wherein the sexually transmittedpathogen is at least one selected from human immunodeficiency virus(HIV), herpes simplex virus (HSV), human papilloma virus (HPV),Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Haemophilusducreyi (HD).
 29. A pharmaceutical composition comprising an effectiveamount of at least one compound according to claim 1, in combinationwith a pharmaceutically acceptable carrier, additive or excipient. 30.The pharmaceutical composition according to claim 29, wherein thecomposition is in the form of a solution, suspension, capsule, tablet,film, pessary, gel, cream, ointment, or spray.
 31. The pharmaceuticalcomposition according to claim 29, wherein the compound is in the rangeof about 0.01-99% by weight.
 32. The pharmaceutical compositionaccording to claim 31, wherein the compound is in the range of about0.1-10% by weight.
 33. A method of preventing or reducing transmissionof sexually transmitted pathogen, comprising administering to a personin need of a therapeutically effective amount of the compound accordingto claim 27 or a pharmaceutically acceptable salt thereof.
 34. Themethod of claim 33, wherein the sexually transmitted pathogen is atleast one selected from human immunodeficiency virus (HIV), herpessimplex virus (HSV), human papilloma virus (HPV), Chlamydia trachomatis(CT), Neisseria gonorrhoeae (NG), and Haemophilus ducreyi (HD).
 35. Themethod of claim 34, wherein the sexually transmitted pathogen is HIV.36. The method according to claim 33, wherein the compound isadministered via or applied to a mucous membrane.
 37. The methodaccording to claim 36 wherein the mucous membrane is in the vagina,anus, rectum, or mouth.
 38. The method according to claim 33 wherein thecompound is administered over the penis.
 39. A method of treatinginfection or preventing or reducing transmission of sexually transmittedpathogen, comprising administering to a person in need of atherapeutically effective amount of the compound according to claim 1,or a pharmaceutically acceptable salt thereof, wherein the nucleoside is3′-fluoro-2′,3′-deoxythymidine (FLT), 3′-azido-3′ deoxythymidine(zidovudine, AZT), 2′,3′-dideoxy-3′-thiacytidine (3TC),2′,3′-dideoxy-didehydro-2′,3′-deoxythymidine (d4T),2′,3′-dideoxycytidine (ddC), or(−)-β-2′,3′-dideoxy-5-fluoro-3′-thiacytidine (FTC).
 40. The method ofclaim 39, wherein the sexually transmitted pathogen is at least oneselected from human immunodeficiency virus (HIV), herpes simplex virus(HSV), human papilloma virus (HPV), Chlamydia trachomatis (CT),Neisseria gonorrhoeae (NG), and Haemophilus ducreyi (HD).
 41. The methodof claim 40, wherein the sexually transmitted pathogen is HIV.
 42. Themethod according to claim 39, wherein the compound is administered viaor applied to a mucous membrane.
 43. The method according to claim 42wherein the mucous membrane is in the vagina, anus, rectum, or mouth.44. The method according to claim 39 wherein the compound isadministered over the penis. 45-92. (canceled)
 93. A method ofpreventing pregnancy comprising administering to a person in need of atherapeutically effective amount of nucleoside-cellulose sulfateconjugate, a pharmaceutically acceptable salt thereof, or anynucleoside, nucleotide, non-nucleoside or compound of claim 1,conjugated to cellulose sulfate or another anionic compounds displayingcontraceptive properties, such as polycarboxylic acid-based polymers.94. The method according to claim 93, wherein the compound isadministered vaginally. 95-113. (canceled)